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Neurological complications of balloon angioplasty in children
E P Treacy1, W J Duncan, M J Tyrrell
1Department of Pediatrics, University Hospital, Saskatoon, Saskatchewan, Canada.
Insights
Balloon angioplasty in children may lead to cerebrovascular accidents, such as stroke. This potential complication should be considered when evaluating the risks and benefits of this pediatric cardiac intervention.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Neurology
Background:
- Balloon angioplasty is a common procedure for treating congenital heart defects in children.
- Established complications include vessel dissection, thrombosis, and bleeding.
- Cerebrovascular complications have been rarely reported.
Observation:
- Two pediatric patients developed cerebrovascular accidents following balloon angioplasty.
- Both patients experienced right temporoparietal infarcts in the territory of the right middle cerebral artery.
- The procedures involved angioplasty for aortic stenosis and native coarctation of the aorta.
Findings:
- Balloon angioplasty, particularly for aortic stenosis and coarctation of the aorta, carries a risk of cerebrovascular accidents (stroke) in children.
- These events manifest as ischemic infarcts in specific cerebral vascular territories.
Implications:
- Cerebrovascular accidents should be recognized as a potential complication of pediatric balloon angioplasty.
- This finding necessitates re-evaluation of the risk-benefit profile for this interventional procedure in pediatric patients.
- Further research into preventative strategies and risk stratification is warranted.
Abstract:
We report on the occurrence of cerebrovascular accidents as a possible complication of balloon angioplasty in children. The first patient underwent balloon angioplasty for aortic stenosis and subsequently developed a right temporoparietal infarct in the vascular territory of the right middle cerebral artery. The second patient developed a right temporoparietal infarct also in the vascular territory of the right middle cerebral artery following balloon angioplasty of native coarctation of the aorta. This experience suggests that, in addition to the previously reported complications of balloon angioplasty, the occurrence of a potential cerebrovascular accident must be considered in the risk-benefit analysis of this procedure.